Metabolic Signature of Type 2 Diabetes, Insulin Resistance, and Obesity Triad

A special issue of Metabolites (ISSN 2218-1989). This special issue belongs to the section "Endocrinology and Clinical Metabolic Research".

Deadline for manuscript submissions: 30 April 2026 | Viewed by 890

Special Issue Editor


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Guest Editor
1. Department of Diabetes, Nutrition and Metabolic Diseases, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2. Clinic of Diabetes, Nutrition and Metabolic Diseases, Emergency County Hospital, 200642 Craiova, Romania
Interests: metabolic diseases epidemiology; biochemical and molecular biomarkers of obesity and diabetes; entero-insular axis; insulinresistance; obesity cardio-metabolic phenotypes
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Special Issue Information

Dear Colleagues,

Metabolic diseases represent a major challenge and a public health problem worldwide, obesity and type 2 diabetes being the most prevalent metabolic disorders causing serious short- and long-term adverse health outcomes and comorbidities.

In recent years, two atypical phenotypes of obesity have been described - metabolically healthy obesity, which is not associated with insulin resistance or cardiometabolic profile characteristic of obesity, and metabolically unhealthy normal weight, characterized by the presence of insulin resistance in normal weight individuals.

However, despite the high prevalence of obesity, atypical obesity phenotypes, and type 2 diabetes, the exact etiology is poorly understood, and there is still debate regarding the molecular pathways and metabolic signature, the diagnostic threshold to apply for identification of the cardiometabolic phenotypes of obesity, and the optimal therapeutic strategies.

In recent years, new biochemical and molecular biomarkers, including genetic variants, DNA methylation, specific miRNAs, microbiota, microbial metabolites, mitochondrial dysfunction, adipocytokines, metabolomic profiles, the entero-insular axis, and the neuro-adipocyte axis, have garnered significant interest in the diagnosis and prognosis of the metabolic triad.

This Special Issue will be dedicated to the impact of microbiota, genetic, epigenetic and neuro-endocrino-metabolic factors on pathogenesis and diagnosis of the obesity, insulin resistance and type 2 diabetes triad, welcoming all those studies that will help to identify future diagnostic approaches for the detection of obesity cardiometabolic phenotypes and evaluate personalized and effective nutrition and pharmacological strategies for prevention and management of metabolic triad.

Dr. Simona Georgiana Popa
Guest Editor

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Keywords

  • cardiometabolic phenotypes of obesity
  • metabolomic profiles
  • microbiota
  • entero-insular axis
  • adipocytokines
  • precision therapy
  • insulin resistance
  • type 2 diabetes

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Published Papers (1 paper)

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15 pages, 267 KB  
Article
Body Adiposity Indices, Adipokines Profile, and CNR1 Polymorphisms in Atypical Phenotypes of Obesity
by Simona Georgiana Popa, Loredana Maria Marin, Loredana Maria Dira, Ana Cristina Tudosie and Andreea Loredana Golli
Metabolites 2026, 16(2), 91; https://doi.org/10.3390/metabo16020091 - 25 Jan 2026
Viewed by 570
Abstract
Background/Objectives: Insulin-Resistant Normal Weight and Insulin-Sensitive Obesity are atypical cardiometabolic phenotypes whose clinico-biological features, management, and prognosis are a subject of extensive scientific debate. The current study aimed to assess the prevalence of metabolic phenotypes of obesity and to evaluate their association with [...] Read more.
Background/Objectives: Insulin-Resistant Normal Weight and Insulin-Sensitive Obesity are atypical cardiometabolic phenotypes whose clinico-biological features, management, and prognosis are a subject of extensive scientific debate. The current study aimed to assess the prevalence of metabolic phenotypes of obesity and to evaluate their association with markers related to diabesity, adipokines profile, and two single nucleotide polymorphisms of CNR1 gene. Methods: We performed a cross-sectional analysis in a random sample of 487 individuals (53.03 ± 13.71 years, 48.3% male) which were classified based on body mass index (</≥25 kg/m2) and insulin resistance (HOMA-IR cut-off value 2.5) as Insulin-Sensitive/Insulin-Resistant Normal Weight (ISNW/IRNW) and Insulin-Sensitive/Insulin-Resistant Obesity (ISO/IRO). Results: The ISO phenotype frequency was 24.2%, with a higher prevalence in the 40–60 years age group (47.0%) and in men (44.9%), while the prevalence of IRNW was 7.0%, predominating in women (61.8%). Participants with IRNW had a more altered glycoregulation profile (fasting and 2 h OGTT blood glucose, prediabetes, and hyperinsulinism), hypercholesterolemia, and adiposity indices (ABSI) than those with ISNW, but comparable to those with IRO. Participants with ISO had a more favorable glycoregulation profile, lipid profile, adipocytokines, and adiposity indices than those with IRO. IRNW had higher odds of being associated with prediabetes (OR 10.75; p < 0.001) than ISNW, while younger age, CUN-BAE, and ABSI were independently associated with both ISO and IRNW phenotypes. Conclusions: The IRNW phenotype should be actively evaluated to intervene on the cardiometabolic risk, while further studies are needed to confirm the sustainability of the favorable cardiometabolic profile of the ISO phenotype. Full article
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